Metabolic Alterations in Women with Lipedema Compared to Women with Lifestyle-Induced Overweight/Obesity

Lipedema is a chronic disorder characterized by disproportionate fat accumulation in the extremities, predominantly affecting women. Unlike obesity, lipedema might be associated with a lower prevalence of metabolic alterations despite often coexisting with overweight or obesity. Fat distribution plays a crucial role in metabolic differences, with gynoid fat in lipedema being associated with a lower risk of insulin resistance and cardiovascular disease. The present study aims to compare biochemical parameters between women with lipedema and those with lifestyle-induced overweight/obesity. Methods: This study involved 108 women, including 53 with lipedema and 55 with lifestyle-induced overweight/obesity. Anthropometric measurements and body composition analyses were conducted, and biochemical parameters related to liver function, lipid profile, kidney and thyroid function, uric acid levels, and carbohydrate metabolism were assessed. Statistical comparisons were made between groups, and multivariate models were used to explore the relationships between disease type, metabolic parameters, and body composition. Results: Women with lipedema exhibited a more favorable metabolic profile than those with overweight/obesity. Dyslipidemia was observed in ~50% of the lipedema group, compared to nearly 70% in the overweight/obesity group. Impaired glucose metabolism and insulin resistance were significantly less prevalent in the lipedema group (18.9% vs. 43.6%, p < 0.05). Conclusions: Despite having a high BMI, women with lipedema demonstrate fewer metabolic alterations than those with overweight/obesity. Fat distribution, rather than overall adiposity, appears to influence metabolic risk. These findings highlight the need for targeted therapeutic approaches to lipedema, distinct from conventional obesity management strategies.